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Lesson
Understanding and addressing the needs of all those involved in the sector. The health system requires two types of personnel: (i) health services providers; and (ii) administrative personnel responsible for planning, budgeting, resource allocation, and monitoring. Both need to be involved.

Project Number: 47137-003, 47137-006
Project Name: Health Sector Governance Program (Subprograms 1 and 2)
Report Date:
Lesson
The implementation arrangements ensured that the provincial health offices, as implementing agencies, were stakeholders of the reforms. Rather than simply following instructions from the center, the provinces were involved in the program, better understood the reform objectives, and supported the implementation of the HSRS.

Project Number: 47137-003, 47137-006
Project Name: Health Sector Governance Program (Subprograms 1 and 2)
Report Date:
Lesson
Intersector coordination. ADB involvement in the financial sector facilitated dialogue with and support from the MOF and ensured better harmonization of the financial systems from different sectors. This support from one key sector, for instance, reinforced effectiveness of the reforms and is likely to enhance the sustainability of the program.

Project Number: 47137-003, 47137-006
Project Name: Health Sector Governance Program (Subprograms 1 and 2)
Report Date:
Lesson
Better data and information. A better use of more accurate data for planning and budgeting by newly trained personnel at the central, provincial, and district levels could have significantly improved allocative efficiency in the health sector, enabling better targeted policies and activities in operational and development plans.

Project Number: 47137-003, 47137-006
Project Name: Health Sector Governance Program (Subprograms 1 and 2)
Report Date:
Lesson
Implementation of government’s priorities. Involving the provincial and district levels and strengthening their capacity to identify and address the local needs reflected the government’s Sam Sang initiative, giving provinces and the districts more responsibilities and authorities. The reforms offered an opportunity to effectively apply the new policy, resulting in a strong government support for HSGP. ADB’s capacity-building activities at the provincial level in previous health projects provided useful experience to better target technical support at all levels.

Project Number: 47137-003, 47137-006
Project Name: Health Sector Governance Program (Subprograms 1 and 2)
Report Date:
Lesson
Following wider lessons learned from ADB projects, recruitment of a single specialist to support implementation and monitoring of both gender and safeguards technical areas is insufficient.

Project Number: 41505-012, 41507-012, 41508-013
Project Name: Second Greater Mekong Subregion Regional Communicable Diseases Control Project
Report Date:
Lesson
In public health projects, it is important that the underlying results chain have adequate components to ensure the welfare of ultimate beneficiaries, and not just confined to serving the involved agencies and their stakeholders.

Project Number: 41505-012, 41507-012, 41508-013
Project Name: Second Greater Mekong Subregion Regional Communicable Diseases Control Project
Report Date:
Lesson
Assessing and clarifying the indirect economic welfare generated by the provision of public goods is essential since these are not readily evident, especially in a regional context.

Project Number: 41505-012, 41507-012, 41508-013
Project Name: Second Greater Mekong Subregion Regional Communicable Diseases Control Project
Report Date:
Lesson
Regular or periodic harmonization of policies is essential in a regional project in which a number of countries, with different levels of development, are engaged together to deliver regional public goods.

Project Number: 41505-012, 41507-012, 41508-013
Project Name: Second Greater Mekong Subregion Regional Communicable Diseases Control Project
Report Date:
Lesson
The initial indicators for assessing the benefits can be refined during implementation to yield reliable results.

Project Number: 41505-012, 41507-012, 41508-013
Project Name: Second Greater Mekong Subregion Regional Communicable Diseases Control Project
Report Date:
Lesson
The successful implementation of HSDP is the result of ADB’s long-term commitment to the health sector in the Lao PDR. Long-term commitment and policy dialogue built on trust and confidence between ADB and MOH, and the government, in general. The SDP modality was proposed by ADB in 2007 for the Health System Development Project but MOH was not yet confident enough about the support of MOF. Policy dialogue continued and in 2009, MOH and MOF were ready for an SDP approach.

Project Number: 41376-022
Project Name: Lao People’s Democratic Republic: Health Sector Development Program
Report Date:
Lesson
Need to better identify barriers to access and use of primary health care services by the intended beneficiaries. HSDP addressed supply-side issues, but demand for services needs to be increased and oriented through better information and communication, and social marketing addressed to the beneficiaries. The health sector needs to mobilize other sectors to achieve health for all. Some barriers cannot be reduced by the health sector alone.

Project Number: 41376-022
Project Name: Lao People’s Democratic Republic: Health Sector Development Program
Report Date:
Lesson
An SDP approach increases the transaction costs compared with a programmatic approach. It is, however, a useful transition in supporting the development of a sector, and in establishing collaboration between MOF and line ministries (such as MOH or others). A CDTA grant or loan attached to an SDP or a program increases the chances of successful development of the sector.

Project Number: 41376-022
Project Name: Lao People’s Democratic Republic: Health Sector Development Program
Report Date:
Lesson
The adequacy and appropriateness of project design have to be tailored to the project’s ultimate objectives and complexities. The PCR provided weak justification of the relevance of the extension and the insufficiency of indicators.

Project Number: 39662-012, 39662-022
Project Name: Prevention and Control of Avian Influenza in Asia and the Pacific
Report Date:
Lesson
No additional lesson.

Project Number: 32313-012
Project Name: Lao People’s Democratic Republic: Health System Development Project
Report Date: